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The NHS is standing on a "burning platform" because its current model is not fit to serve the public, the country’s most senior hospital inspector has warned.

Prof Sir Mike Richards said radical changes were needed to improve the safety record of hospitals across the country - with four in five found to be in need of improvement.

Of 136 acute trusts inspected, just one got top marks for safety, the audit found.

The findings from inspections of every trust in the country found that dangers to patients were a “real concern”.

Sir Mike said that for many hospitals, it seemed “almost impossible” to provide safe care while modernising services.

But he said such changes were vital to meet the needs of the public, now and in the future.

“The model of acute care that once worked well cannot continue to meet the needs of today’s population,” he said.

“The NHS now stands on a burning platform - the need for change is clear, but finding the resources and energy to deliver that change while simultaneously providing safe patient care can seem almost impossible.”

The report highlights hospital overcrowding, long waits for patients with life-threatening conditions, staff shortages and poor control of infections. Ambulances queuing outside A&E "has been normalised and is routine" the study found.

Sir Mike said today’s pressures were “unprecedented”.

But he said that the best hospitals had made radical changes in the way they worked.

In particularly, he highlhighted schemes in which hospitals had sent out doctors and nurses to treat patients in their own homes, and in care homes, instead of filling up beds needlessly.

In other areas, pharmacists had been sent in to care homes, to review patients’ medications, he said.

“This is about going to where the patients are, whether that is in their own homes, or in care homes,” he said. “This is about hospitals, GPs, district nurses and community services all working much more closely together.”

Sir Mike said a "failure to learn" when things go wrong was adding to safety risks.

Overall, 81 per cent of the 136 non-specialist trusts were deemed to be inadequate or to require improvement for safety. Some 11 per cent of hospital trusts were given the lowest rating for safety.

More than half of specialist trusts were rated as requiring improvement in terms of safety.

The report states: "We are also concerned that some may be over-reliant on their reputation and not assuring themselves of the quality of care they are delivering."

The NHS now stands on a burning platform – the need for change is clear, but finding the resources and energy to deliver that change while simultaneously providing safe patient care can seem almost impossibleProf Sir Mike Richards

Across 199 urgent and emergency services inspected, 7 per cent were deemed to be inadequate.

Urgent and emergency services and medical care had more ratings of inadequate and requiring improvement than good or outstanding, the report said.

The CQC said the proportion of urgent and emergency services rated inadequate reflects that many such services are struggling to cope with increasing numbers of patients.

The regulator introduced a new inspection programme in 2013, following the publication of the public inquiry report into the care scandal at Mid Staffordshire NHS Foundation Trust.

It has inspected all NHS acute and specialist hospital trusts under the new regime.

Sir Mike said: "We have witnessed some fantastic care and examples of innovative practice, but we have also found a wide variation in quality both between hospitals and between services within the same hospital.

"Safety remains a real concern, often due to a failure to learn when things go wrong.

"Strong leadership that instils a culture of learning and an environment where staff are listened to can play a vital part in bringing about improvements.

"Overwhelmingly, we see staff behaving in a caring way, which is supported by what we hear from patients. The unwavering dedication and commitment of staff shines out from our inspection reports.

"What is clear is that while staff continue to work hard to deliver good care, the model of acute care that once worked well cannot continue to meet the needs of today's population.

"The NHS now stands on a burning platform – the need for change is clear, but finding the resources and energy to deliver that change while simultaneously providing safe patient care can seem almost impossible.

"What this report demonstrates, however, is that transformational change is possible, even in the most challenging of circumstances – we have witnessed it, and seen the evidence that making practical changes to the way that care is delivered can benefit patients."

His foreword to the report adds: "The scale of the challenge that hospitals are now facing is unprecedented – rising demand coupled with economic pressures are creating difficult-to-manage situations that are putting patient care at risk."

An NHS England spokesman said: "CQC are right to praise dedicated NHS staff for delivering great care under pressure, and they are also right to argue for the more profound changes now being planned in how acute hospital care is delivered across England."